Updated 30 May 2014

Mediterranean or carb-free: which diet is best for your brain?

The number of people living with dementia is increasing at an alarming rate. Could our dietary choices help prevent our brain cells from deteriorating?

The field of nutrition appears to be in a state of constant flux. This is also true for the dietary approach to preventing dementia or Alzheimer’s Disease.

On the one hand proponents such as Dr David Perlmutter, the author of a book entitled Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar - Your Brain’s Silent Killers advocate banning wheat, gluten, carbohydrates and sugar from the diet to keep your brain pristine well into old age (Stetka & Perlmutter, 2014).

On the other hand, a team of eleven leading doctors from the G8 countries wrote a letter to the British Prime Minister David Cameron and his Minister of Health Jeremy Hunt, urging them to emphasis the importance of diet and lifestyle factors and the Mediterranean Diet in particular, in reducing the risk of dementia in global populations, shortly before the start of the summit on new approaches to research and treatment of dementia (Collins, 2013). The Mediterranean Diet contains wheat and gluten, carbohydrates, legumes and starchy vegetables.

So which theory should we believe and which diet should we follow to ensure that our brain cells remain feisty until the day we “shuffle off this mortal coil” as Shakespeare put it so elegantly?

The answer to this conundrum is that we honestly don’t know yet which diet is going to benefit people in general and also keep their brain cells from deteriorating.

Read: Boost your brain power

Symptoms of Alzheimer’s Disease

Dementia, of which Alzheimer’s Disease is probably the most common, but not the only cause, is associated with the following typical symptoms:
  • Problems experienced when carrying out familiar tasks - patients may no longer be able to do everyday tasks for themselves or others (preparing meals, shaving, dressing)
  • Losing skills associated with performing a job - patients may forget skills they have used successfully for many years when it comes to performing their work and become so confused that they eventually are unable to hold down a job any longer
  • Loss of language skills - the patient forgets words to such an extent that he or she can no longer communicate properly and may substitute inappropriate phrases for the forgotten word, not only when speaking, but also when writing
  • Disorientation and confusion of time and place - the patient is lost even in familiar surroundings and loses touch with time
  • Faulty judgement - patients may make uncharacteristic impulsive and dangerous decisions such as suddenly leaving the house without any clothes or donating a large sum of money to strangers
  • Lack of the facility for abstract thought - the patient no longer has the ability to think of abstract constructs such as numbers or how to use them (e.g. doing mental arithmetic)
  • Misplacing things in inappropriate places - patients may store their shoes in the fridge and their food in the clothes cupboard
  • Disconcerting mood swings - patients may go from being peaceful to raging anger in a few seconds for no reason or burst into tears and cry for long periods without cause
  • Rapid and dramatic personality changes - switching from being an introvert to an extrovert or vice versa at a late age should be a warning sign
  • Withdrawal and lack of interest and initiative - patients may become reclusive, sleep all day and have no interest in any aspect of normal life.
    (, 2014)

As was repeatedly emphasised by experts in the field and the attending politicians at the G8 Dementia Summit held in London on the 11th of December 2013,  “We recognise that dementia is not a normal part of ageing. It is a condition that impairs the cognitive brain functions of memory, language, perception and thought and which interferes significantly with the ability to maintain the activities of daily living.” (G8 UK, 2013)

In view of the fact that there are already more than 35 million people worldwide suffering from dementia, a figure that is expected to double in the following two decades, and that the costs of care associated with this condition are already estimated to exceed US$604 billion, dementia is a serious threat which requires a solution sooner, rather than later (G8 UK, 2013).

Read: 135 million will have dementia by 2050

Diet solutions

While the G8 Dementia Summit have issued an undertaking to commit themselves to engage in research and to find “a cure or a disease-modifying therapy for dementia by 2025" (G8 UK, 2013), people struggling with the problems of dementia in 2014, will turn to any suggested cure that promises relief. It is, thus understandable that various diets should also be promising patients a solution for dementia. As mentioned above, two of these diets are the Anti-Gluten/Wheat/Carb policy suggested by Dr Perlmutter (and a host of other enthusiastic anti-carb lobbyists) and the Mediterranean Diet which receives support from leading physicians in the field of dementia research, including Dr Claire Gerada, previous chairman of the Royal College of General Practitioners in the UK (The Times, 2013).

The Mediterranean Diet is rich in complex carbohydrates, vegetables, fruit, including wine (in moderation), monounsaturated fats and oils (including olives, avocado, and olive oil), yoghurt and cheeses, pulses, fish, and seafood (good sources of omega-3 fatty acids), and contains very little red meat. The Mediterranean Diet can, therefore, be regarded as more balanced and probably much easier to stick to than the Zero-carb, High-protein, High-fat diets proposed by so many authors of diet books that are currently all the rage.

Read: Go the Mediterranean route


It has been said that we will soon “be held to ransom” by the demographics of our ageing populations. We live longer, but more and more people who grow older suffer from dementia and increase the burden on our healthcare systems. We need to do something positive about the situation right now and not wait till 2025.

Just from an economic point of view, the Mediterranean Diet is less expensive to put into practice than the No-carb Diets. It is also much more varied and it has sustained countless populations living around the Mediterranean Sea for millennia. A recent review of studies comparing diets, showed that 9 out of 12 studies linked the Mediterranean Diet to improved cognitive function, reduced deterioration of the brain and a lower risk of Alzheimer’s Disease. Prior studies have showed that the Mediterranean Diet also helps to lower the risk of heart disease, hypertension and diabetes mellitus (Alzheimer’s Research, 2013; The Times, 2013).

While many South Africans probably regard High-protein, High-fat diets as bliss and part of their heritage, making modest changes to your food intake will not only improve your physical healthy, but may just keep your brain sprightly for years to come. What worked for people like Homer and Pythagoras, and all the other brilliant luminaries living around the Middle Sea, will probably also help to keep our brains going. 

(References: (2014). Alzheimer’s Symptoms. Fisher Center for Alzheimers Research Foundation; Alzheimer’s Research (2013). Research links Mediterranean diet to lower risk of cognitive decline. Published 30 April 2013; Collins N (2013). Mediterranean Diet key to dementia battle, PM told ; G8 UK (2013). G8 Summit Communique.; Stetka BS, Perlmutter D (2014). Dementia: Is gluten the culprit? Medscape, 21 Jan, 2014; The Times (2013). Eat fruit, veg, fish, oil to beat dementia. The Times, p. 15, 10 Dec 2013.)

(Image illustrating brain function loss from Shutterstock)

Read more:
Mediterranean diet keeps dementia at bay
Why your brain needs fish
Fit in your 40s staves off dementia

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Read more of her articles.


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